Treatment strategy and outcome of surgical treatment for an atheromatous pseudo- occlusion of the internal carotid artery

Atheromatous pseudo-occlusion (APO) of the internal carotid artery (ICA) is defined as an angiographically occluded but anatomically patent carotid artery. APO of the ICA has been further subdivided from carotid near occlusion, and is defined as a more severe stenosis. Since carotid angiography shows a nearly occluded ICA at the origin, APO represents a difficult diagnostic problem. Fifteen patients with APO underwent CEA. Intraoperatively, a patent but collapsed ICA distal to localized atheromatous plaque was recognized in all cases. Clinical features, radiological findings and operative records were all retrospectively examined. In fourteen patients the ICA lumen was opened by CEA and dilatation to produce a sufficient antegrade flow was possible. Our data suggest that CEA is a logical treatment of choice for APO.